Obsessive-Compulsive (OCD) Counselling in Birkenhead

Photo of Victoria Lacey - GetCBT (Victoria Lacey, CBT Therapist Wirral), MBABCP, Psychotherapist
GetCBT (Victoria Lacey, CBT Therapist Wirral)
Psychotherapist, MBABCP
Verified Verified
2 Endorsed
Birkenhead CH63
Looking for an Anxiety Specialist? Therapy should be a partnership, that capitalises on your knowledge of your history and self, and your therapists knowledge of how go apply gold standard evidence based interventions and treatments to make you feel better. I started GetCBT to provide you with a First Class Psychotherapy experience working with Depression & Low self-esteem & specialising in Anxiety & Panic Attacks, Worry, OCD, PTSD, Phobia's, Social Anxiety & Health Anxiety. Check out our Google and Trustpilot reviews to hear about others’ experience of working with me.
Looking for an Anxiety Specialist? Therapy should be a partnership, that capitalises on your knowledge of your history and self, and your therapists knowledge of how go apply gold standard evidence based interventions and treatments to make you feel better. I started GetCBT to provide you with a First Class Psychotherapy experience working with Depression & Low self-esteem & specialising in Anxiety & Panic Attacks, Worry, OCD, PTSD, Phobia's, Social Anxiety & Health Anxiety. Check out our Google and Trustpilot reviews to hear about others’ experience of working with me.
0151 453 3877 View 0151 453 3877
Photo of Holly Driver Dos Santos, MSc, MBABCP, Psychotherapist
Holly Driver Dos Santos
Psychotherapist, MSc, MBABCP
Verified Verified
Birkenhead CH41
I can treat panic, generalised anxiety, social anxiety, phobias, OCD, PTSD, depression and anxiety and low mood associated to low self esteem. I will always offer a psychological assessment as the first CBT session, so can advise at the end of the first session of a provisional diagnosis and whether CBT is likely to help. The therapy is goal- focused, evidence-based, and involves making changes with my support to overcome your difficulties. It can be extremely difficult to know what your goals are when highly anxious or depressed, so I can help you to work out what you are aiming to change. I can help you if aged 16 or above.
I can treat panic, generalised anxiety, social anxiety, phobias, OCD, PTSD, depression and anxiety and low mood associated to low self esteem. I will always offer a psychological assessment as the first CBT session, so can advise at the end of the first session of a provisional diagnosis and whether CBT is likely to help. The therapy is goal- focused, evidence-based, and involves making changes with my support to overcome your difficulties. It can be extremely difficult to know what your goals are when highly anxious or depressed, so I can help you to work out what you are aiming to change. I can help you if aged 16 or above.
0151 453 4586 View 0151 453 4586
Photo of Jessica Young, MSc, MBABCP, Psychotherapist
Jessica Young
Psychotherapist, MSc, MBABCP
Verified Verified
Birkenhead CH41
I use evidence-based CBT techniques to treat problems such as depression, OCD, PTSD, Social Anxiety Disorder, low self-esteem, generalised anxiety, panic disorder.
I'm fully qualified and accredited Cognitive Behavioural Therapist (CBT), an EMDR (Eye Movement Desensitisation & Reprocessing) therapist, a CBT supervisor and owner at Your Therapy with Jess. I am renowned for my warm and non-judgemental approach and my priority is getting your mental health back on track. I am an experienced NHS psychotherapist with 10 years experience delivering CBT and 7 years delivering EMDR. I offer EMDR for PTSD, and CBT for depression and anxiety disorders for clients over 17 years old (both therapies can be in person or remote). I also offer clinical supervision to trainee and qualified CBT therapists.
I use evidence-based CBT techniques to treat problems such as depression, OCD, PTSD, Social Anxiety Disorder, low self-esteem, generalised anxiety, panic disorder.
I'm fully qualified and accredited Cognitive Behavioural Therapist (CBT), an EMDR (Eye Movement Desensitisation & Reprocessing) therapist, a CBT supervisor and owner at Your Therapy with Jess. I am renowned for my warm and non-judgemental approach and my priority is getting your mental health back on track. I am an experienced NHS psychotherapist with 10 years experience delivering CBT and 7 years delivering EMDR. I offer EMDR for PTSD, and CBT for depression and anxiety disorders for clients over 17 years old (both therapies can be in person or remote). I also offer clinical supervision to trainee and qualified CBT therapists.
0151 453 3289 View 0151 453 3289
Photo of Lee Rowland, MBACP, Counsellor
Lee Rowland
Counsellor, MBACP
Verified Verified
Birkenhead CH41
I am a trusted Psychodynamic/CBT Therapist. I have helped many break through the obstacles holding them back; Life’s too short to be unhappy, unsure or unfulfilled. Let me help you learn and develop better ways to handle the issues that are standing in the way of your goals. I am proficient in issues including, Early Life Experiences, ADHD, Addiction, Alcohol/Drug issues, OCD/Phobias, Anxiety/Depression, Work Related Stress, PTSD, Autistic Spectrum, Bereavement, Anger Management, Domestic Violence, Panic Disorder.
I am a trusted Psychodynamic/CBT Therapist. I have helped many break through the obstacles holding them back; Life’s too short to be unhappy, unsure or unfulfilled. Let me help you learn and develop better ways to handle the issues that are standing in the way of your goals. I am proficient in issues including, Early Life Experiences, ADHD, Addiction, Alcohol/Drug issues, OCD/Phobias, Anxiety/Depression, Work Related Stress, PTSD, Autistic Spectrum, Bereavement, Anger Management, Domestic Violence, Panic Disorder.
0151 453 6765 View 0151 453 6765
Photo of Seham Hariz - Mind Clarity CIC, MBACP, Counsellor
Mind Clarity CIC
Counsellor, MBACP
Verified Verified
Birkenhead CH41
We offer a variety of counsellors who have various specialties and languages to fit a range of client needs, desires and wants. We cater to several types of clients whether it be addiction, emotional stress, mental health, or culturally related. We also offer dedicated FREE counselling for Asylum Seekers and Refugees in the Wirral Languages we offer: English, Farsi, Urdu, Russian, Ukrainian, Arabic, Polish, Spanish and Albanian!
We offer a variety of counsellors who have various specialties and languages to fit a range of client needs, desires and wants. We cater to several types of clients whether it be addiction, emotional stress, mental health, or culturally related. We also offer dedicated FREE counselling for Asylum Seekers and Refugees in the Wirral Languages we offer: English, Farsi, Urdu, Russian, Ukrainian, Arabic, Polish, Spanish and Albanian!
0151 453 0532 View 0151 453 0532
Photo of Anthony Lacey (Msc) - Anthony Lacey Psychotherapy
Anthony Lacey Psychotherapy
Verified Verified
Birkenhead CH25
Are you not feeling like you are getting the most out of life and feel somewhat stuck in some way? Maybe you notice that your over-reacting with certain people or when in certain places or situations? Do you avoid doing certain things due to overwhelming feelings? Are you feeling unhelpful amounts of guilt/shame, feel unsafe in someway or out of control? If so, I can help you work through these by tailoring your sessions to your individual needs so that you learn about your self, start working towards your goal(s) and then start become self-sufficient with regard to what life throws at you.
Are you not feeling like you are getting the most out of life and feel somewhat stuck in some way? Maybe you notice that your over-reacting with certain people or when in certain places or situations? Do you avoid doing certain things due to overwhelming feelings? Are you feeling unhelpful amounts of guilt/shame, feel unsafe in someway or out of control? If so, I can help you work through these by tailoring your sessions to your individual needs so that you learn about your self, start working towards your goal(s) and then start become self-sufficient with regard to what life throws at you.
0151 318 0431 View 0151 318 0431

More Therapists Nearby

Photo of Cheryl Overington - Heswall Hills Counselling Centre, DCounsPsych, HCPC - Couns. Psych., Psychologist
Heswall Hills Counselling Centre
Psychologist, DCounsPsych, HCPC - Couns. Psych.
Verified Verified
Wirral CH60
T, clinical hypnotherapy, adoption, couples therapy, psychosexual therapy, sexual violence, coaching, clinical supervision, OCD, birth trauma, .
Hello, my name is Cheryl Overington and I am a Chartered Counselling Psychologist. I am the Founder and Manager of the Heswall Hills Counselling Centre, a private therapy centre based in Heswall Hills on the Wirral. Finding the right therapist can be a daunting process. All of the therapists working from the centre have been selected by me to ensure that they are suitably trained and most importantly of the sort of therapists I’ll be happy to refer to. Due the number of different therapists, including psychologists and CBT therapists we are able to offer a wide of therapeutic specialities and work with children, adults & couples.
T, clinical hypnotherapy, adoption, couples therapy, psychosexual therapy, sexual violence, coaching, clinical supervision, OCD, birth trauma, .
Hello, my name is Cheryl Overington and I am a Chartered Counselling Psychologist. I am the Founder and Manager of the Heswall Hills Counselling Centre, a private therapy centre based in Heswall Hills on the Wirral. Finding the right therapist can be a daunting process. All of the therapists working from the centre have been selected by me to ensure that they are suitably trained and most importantly of the sort of therapists I’ll be happy to refer to. Due the number of different therapists, including psychologists and CBT therapists we are able to offer a wide of therapeutic specialities and work with children, adults & couples.
07481 361235 View 07481 361235
Photo of Luize Jenkins-King - LJK Psych-Health (Luize Jenkins-King CBT and EMDR), MSc, MBABCP, Psychotherapist
LJK Psych-Health (Luize Jenkins-King CBT and EMDR)
Psychotherapist, MSc, MBABCP
Verified Verified
Wirral CH49
Not accepting new clients
Feeling stressed, tense or worried at certain times in life is a normal human response. For some people, anxiety becomes overwhelming and persists to the point that fear significantly impacts daily life which can lead to low mood and low self-esteem. Anxiety can also develop into more specific areas such as social anxiety, panic attacks or OCD. If you experience any of these and would like to learn to manage your symptoms then I can help. I have experience/I am trained in treating people experiencing Long Term Health Conditions and also have significant expertise in treating Depression, Specific Phobias, Health Anxiety and PTSD.
Feeling stressed, tense or worried at certain times in life is a normal human response. For some people, anxiety becomes overwhelming and persists to the point that fear significantly impacts daily life which can lead to low mood and low self-esteem. Anxiety can also develop into more specific areas such as social anxiety, panic attacks or OCD. If you experience any of these and would like to learn to manage your symptoms then I can help. I have experience/I am trained in treating people experiencing Long Term Health Conditions and also have significant expertise in treating Depression, Specific Phobias, Health Anxiety and PTSD.
0151 318 0787 View 0151 318 0787
Photo of Erin Regan, MBABCP, Psychotherapist
Erin Regan
Psychotherapist, MBABCP
Verified Verified
Wirral CH63
I work with individuals who are dealing with depression or common anxiety problems. These anxiety problems can be Generalised Anxiety, PTSD, OCD, Social Anxiety or Health Anxiety. Often individuals are aware of the difficulties but are not sure where to start. Having motivation and an open curiousness about the process supports the gains individuals can make in therapy. With my extensive skills I assess to find out what the main problems are, taking the view that the individual is an expert in what they are experiencing. I work in a collaborative way to find a solution to reduce the impact of the symptoms on their life.
I work with individuals who are dealing with depression or common anxiety problems. These anxiety problems can be Generalised Anxiety, PTSD, OCD, Social Anxiety or Health Anxiety. Often individuals are aware of the difficulties but are not sure where to start. Having motivation and an open curiousness about the process supports the gains individuals can make in therapy. With my extensive skills I assess to find out what the main problems are, taking the view that the individual is an expert in what they are experiencing. I work in a collaborative way to find a solution to reduce the impact of the symptoms on their life.
0151 453 5546 View 0151 453 5546
Photo of Joanne Morley, MBABCP, Psychotherapist
Joanne Morley
Psychotherapist, MBABCP
Verified Verified
2 Endorsed
Wirral CH49
I have over 15 years experience of supporting individuals who struggle with managing mental health and wellbeing. I am able to provisionally diagnose and treat individuals using a range of approaches, all with a strong evidence base to support their use in relieving distress however, I aim to treat the person as an individual, adopting an integrative approach to suit their needs.
I have over 15 years experience of supporting individuals who struggle with managing mental health and wellbeing. I am able to provisionally diagnose and treat individuals using a range of approaches, all with a strong evidence base to support their use in relieving distress however, I aim to treat the person as an individual, adopting an integrative approach to suit their needs.
01923 961432 View 01923 961432
Photo of Julie Kerr - JULIE , BACP, Counsellor
JULIE
Counsellor, BACP
Verified Verified
Wirral CH60
Hi, I am Julie a qualified counsellor based in Wirral. If your feeling anxious, overwhelmed, stressed, lonely, or have low self esteem, it can feel like you are the only one and everyone else is moving forward except you. Within my practice I offer a professional, confidential and compassionate service and I believe that everyone has the capacity to look within themselves and develop happier perspectives within in their lives.
Hi, I am Julie a qualified counsellor based in Wirral. If your feeling anxious, overwhelmed, stressed, lonely, or have low self esteem, it can feel like you are the only one and everyone else is moving forward except you. Within my practice I offer a professional, confidential and compassionate service and I believe that everyone has the capacity to look within themselves and develop happier perspectives within in their lives.
0151 453 4484 View 0151 453 4484
Photo of Erika Kelly - Kind Mind IOM | Erika Kelly (BSc, PGDip,MBABCP)
Kind Mind IOM | Erika Kelly (BSc, PGDip,MBABCP)
Verified Verified
2 Endorsed
Wirral CH30
Cognitive Behavioural Therapy (CBT) is very popular and highly recommended by NICE guidelines as a proven and effective method for managing anxiety, depression, stress, and so much more! As a dedicated CBT psychotherapist and member of the BABCP, I am passionate about supporting people to feel better about and within themselves, ultimately enhancing their quality of life. I currently work with clients aged 16 and older from all backgrounds, utilising a variety of therapeutic techniques to create a friendly and empowering environment, whereby collaboratively, we can develop practical strategies to improve your mental health.
Cognitive Behavioural Therapy (CBT) is very popular and highly recommended by NICE guidelines as a proven and effective method for managing anxiety, depression, stress, and so much more! As a dedicated CBT psychotherapist and member of the BABCP, I am passionate about supporting people to feel better about and within themselves, ultimately enhancing their quality of life. I currently work with clients aged 16 and older from all backgrounds, utilising a variety of therapeutic techniques to create a friendly and empowering environment, whereby collaboratively, we can develop practical strategies to improve your mental health.
01255 444142 View 01255 444142
Photo of Peter Craig Dinsmore, BACP, Psychotherapist
Peter Craig Dinsmore
Psychotherapist, BACP
Verified Verified
1 Endorsed
Wirral CH30
I am a very experienced and professional therapist with over twelve thousand client contact hours behind me in individual, couples and group work. I feel my experience coupled with my life experiences makes me the person and the therapist I am today. My training in the person-centred approach (three years) and in Transactional Analysis (seven years) together with continuing professional and personal development and supervision give me a strong theoretical and experiential focus to bring to my client work. I work very much in a relational way (research indicates that the therapeutic relationship is key to positive therapy outcomes)
I am a very experienced and professional therapist with over twelve thousand client contact hours behind me in individual, couples and group work. I feel my experience coupled with my life experiences makes me the person and the therapist I am today. My training in the person-centred approach (three years) and in Transactional Analysis (seven years) together with continuing professional and personal development and supervision give me a strong theoretical and experiential focus to bring to my client work. I work very much in a relational way (research indicates that the therapeutic relationship is key to positive therapy outcomes)
0151 541 2512 View 0151 541 2512
Photo of Anna Marie Bell, MBACP, Counsellor
Anna Marie Bell
Counsellor, MBACP
Verified Verified
1 Endorsed
Wirral CH49
At any stage in our lives, relationships and events can leave us with deep hurt and confusion that needs professional help. Counselling can give hope and help untangle confusing thoughts and emotions to understand our true selves and our relationships better, leading to a happier life. Experiencing a therapeutic relationship where you are genuinely valued, understood and accepted without judgement, can be in itself healing. As a person-centred creative counsellor, I see the client and therapist as equals. I provide you with a safe, confidential space to explore the issues that you bring.These sessions are yours, to use as you wish.
At any stage in our lives, relationships and events can leave us with deep hurt and confusion that needs professional help. Counselling can give hope and help untangle confusing thoughts and emotions to understand our true selves and our relationships better, leading to a happier life. Experiencing a therapeutic relationship where you are genuinely valued, understood and accepted without judgement, can be in itself healing. As a person-centred creative counsellor, I see the client and therapist as equals. I provide you with a safe, confidential space to explore the issues that you bring.These sessions are yours, to use as you wish.
01352 879966 View 01352 879966
Photo of Janet Susan Aileen Brickwood - With You Counselling , BACP, Counsellor
With You Counselling
Counsellor, BACP
Verified Verified
Wirral CH61  (Online Only)
Hi there, I'm Janet and a qualified person-centred counsellor. I previously worked in Birmingham as a Mental Health Nurse. I retrained as a Counsellor but bring with me all that experience and, I feel most importantly, understanding and empathy, an open-minded, non-judgemental attitude and an honest, genuine way of being with others. With You Counselling practice aims to remain human in each and every contact. As a person-centred Counsellor, I believe that you know yourself and what you need/want best. This is at the forefront of my way of working with each individual. Happy to meet to see if we are a fit. Speak soon!
Hi there, I'm Janet and a qualified person-centred counsellor. I previously worked in Birmingham as a Mental Health Nurse. I retrained as a Counsellor but bring with me all that experience and, I feel most importantly, understanding and empathy, an open-minded, non-judgemental attitude and an honest, genuine way of being with others. With You Counselling practice aims to remain human in each and every contact. As a person-centred Counsellor, I believe that you know yourself and what you need/want best. This is at the forefront of my way of working with each individual. Happy to meet to see if we are a fit. Speak soon!
0151 453 0172 View 0151 453 0172
Photo of Yi-Ping Huang, MA, HCPC-Art Therap., Psychotherapist
Yi-Ping Huang
Psychotherapist, MA, HCPC-Art Therap.
Verified Verified
Wirral CH60
Life and relationships are adventures that take some navigation and practice… I love doing what I do as it involves a lot of watching things shift and people grow. I am often deeply moved by the courage and innate wisdom of the people that I work with. I have been working with children, adults and families. I’m experienced in delivering therapeutic support in community and educational settings. I work collaboratively and respect each individual’s social graces. I can support with stress management, psychosomatic symptoms, developmental trauma, sexual trauma, shock trauma , PTSD , anxiety, low mood/ depression.
Life and relationships are adventures that take some navigation and practice… I love doing what I do as it involves a lot of watching things shift and people grow. I am often deeply moved by the courage and innate wisdom of the people that I work with. I have been working with children, adults and families. I’m experienced in delivering therapeutic support in community and educational settings. I work collaboratively and respect each individual’s social graces. I can support with stress management, psychosomatic symptoms, developmental trauma, sexual trauma, shock trauma , PTSD , anxiety, low mood/ depression.
0151 453 2502 View 0151 453 2502
Photo of Françoise Rutland, PhD, MBACP, Counsellor
Françoise Rutland
Counsellor, PhD, MBACP
Verified Verified
Wirral CH60
​I have a particular interest in working with issues of post-traumatic stress disorder (PTSD), anxiety, and relational issues. My core modality is psychodynamic with integrative counselling, and clinical hypnotherapy with memberships and accreditation with NCPS, BACP and CNHC. I believe that the best therapeutic outcomes directly relate to trust, acceptance and confidentiality between counsellor and client.
​I have a particular interest in working with issues of post-traumatic stress disorder (PTSD), anxiety, and relational issues. My core modality is psychodynamic with integrative counselling, and clinical hypnotherapy with memberships and accreditation with NCPS, BACP and CNHC. I believe that the best therapeutic outcomes directly relate to trust, acceptance and confidentiality between counsellor and client.
0151 453 2731 View 0151 453 2731
Photo of Kate Louise McDonald, MBACP, Psychotherapist
Kate Louise McDonald
Psychotherapist, MBACP
Verified Verified
Prenton CH43
So if you've reached this point I'm guessing you feel like you need some extra support and professional guidance. Life at times for all of us can seem overwhelming and our minds are like overfilled jugs of water or that junk draw that we have in our homes that just doesn't shut. Whatever your issue is, I believe I can help you. Together we can unfold what is going on for you, at your pace and then with my support, we can look at new ways of coping and reach a goal that you would love to achieve. The answers you're looking for, are already inside you. I help you find them, organize them and achieve them.
So if you've reached this point I'm guessing you feel like you need some extra support and professional guidance. Life at times for all of us can seem overwhelming and our minds are like overfilled jugs of water or that junk draw that we have in our homes that just doesn't shut. Whatever your issue is, I believe I can help you. Together we can unfold what is going on for you, at your pace and then with my support, we can look at new ways of coping and reach a goal that you would love to achieve. The answers you're looking for, are already inside you. I help you find them, organize them and achieve them.
0151 453 3084 View 0151 453 3084
Photo of Stephanie Anne Edwards, DCounsPsych, MBACP, Psychotherapist
Stephanie Anne Edwards
Psychotherapist, DCounsPsych, MBACP
Verified Verified
Bebington CH63
I believe each of us have the capacity to grow to reach our true potential. What can influence or inhibit our positive growth? Our life experiences are affected by childhood events, our relationships with parents. siblings, other family members, friendships, work etc, Our soil can be contaminated by others in our lives when we experience childhood trauma, grief, loss, shame and witnessing violence. being in abusive relationships, life and death situations. These experiences influence us as we grow up, our emotions, our beliefs, our thoughts and our behaviours. This can make us feel depressed, anxious, derailed and scared.
I believe each of us have the capacity to grow to reach our true potential. What can influence or inhibit our positive growth? Our life experiences are affected by childhood events, our relationships with parents. siblings, other family members, friendships, work etc, Our soil can be contaminated by others in our lives when we experience childhood trauma, grief, loss, shame and witnessing violence. being in abusive relationships, life and death situations. These experiences influence us as we grow up, our emotions, our beliefs, our thoughts and our behaviours. This can make us feel depressed, anxious, derailed and scared.
07723 441602 View 07723 441602
Photo of Danielle Curtis, MBABCP, Psychotherapist
Danielle Curtis
Psychotherapist, MBABCP
Verified Verified
1 Endorsed
Wirral CH61
A highly experienced dual qualified BABCP Accredited Cognitive Behavioural and Interpersonal Psychotherapist (IPT) with 18 years clinical experience and a background in Forensic, Perinatal and Liaison Psychiatry. I feel passionate about providing high quality, effective and individualized psychotherapy to help you to overcome the challenges that have brought you to therapy by using evidence based approaches and drawing upon your strengths. Together we can help with adjusting to major life changes, self-esteem, anxiety, relationships, coping with stress and supporting you to maximize your potential and move towards a recovery.
A highly experienced dual qualified BABCP Accredited Cognitive Behavioural and Interpersonal Psychotherapist (IPT) with 18 years clinical experience and a background in Forensic, Perinatal and Liaison Psychiatry. I feel passionate about providing high quality, effective and individualized psychotherapy to help you to overcome the challenges that have brought you to therapy by using evidence based approaches and drawing upon your strengths. Together we can help with adjusting to major life changes, self-esteem, anxiety, relationships, coping with stress and supporting you to maximize your potential and move towards a recovery.
0151 453 2313 View 0151 453 2313

See more therapy options for Birkenhead

Obsessive-Compulsive (OCD) Counsellors

How long does OCD treatment take?

Obsessive-Compulsive Disorder (OCD) is often treated on a weekly or twice-weekly schedule, depending on symptom severity and the client’s preferences. Some clients may start to see a noticeable improvement in symptoms in as little as six weeks, but it’s also possible, especially in more severe cases, for treatment to take several months to a year before significant progress is made.

What happens if OCD is not treated?

Some people with OCD, especially those with mild symptoms, may find that they are able to adapt reasonably well to life with the condition, even if their symptoms never resolve completely. However, many people, particularly those whose symptoms are severe at the outset, find that their obsessions and compulsions grow more intrusive with time, making it harder to maintain relationships, hold down a job, or navigate the world successfully.

Are there medications for OCD?

Medication can be used to treat OCD. The class of drugs most often prescribed are selective serotonin reuptake inhibitors, or SSRIs, which include fluvoxamine, fluoxetine, and sertraline, among others. In cases of treatment-resistant OCD, other classes of medication, such as tricyclic antidepressants or atypical antipsychotics, may be prescribed. Medication is frequently used in conjunction with therapy.

Can OCD come back after treatment?

Yes. Major life transitions, periods of stress, or other factors can cause symptoms to return or, if they were never fully eradicated, to ramp back up in intensity. For some, these relapses are brief and do not require additional treatment; identifying specific triggers and practicing the skills learned in therapy can help speed their course. For others, returning to therapy for a brief period can help address the underlying stress and strengthen coping mechanisms.